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Posted (edited)

Hi there

I am a seemingly healthy male of 63 years old.

I have muesli every morning and apart from daily ice cream, cheese or cake (or all) have an otherwise pretty good balanced diet.

I exercise, not fanatically but either cycling or swimming or walking, just about every day.

Stopped heavy drinking and smoking over ten years ago.

Mother and father lived to 95 and 89 (they also had the nerve to stop smoking very late).

Sister, 15 years older, a health professional, after a very "healthy" lifestyle, got angina and stents at about my age now. BUT we discovered in her 60s she's only my half sister! (Stents worked beautifully and she's been very well all this time.)

I am not thin but only a few kilos over. Perfect for cuddling. My body mass index was just before getting fat.

BP excellent usually 110/70 to 120/80.

My cholesterol has been a bit high ever since I started testing about ten years ago in UK, but HDL was over 60 to counteract.

Now get annual tests and LDL climbing slowly, HDL falling a bit.

Latest results:

Cholesterol 298

Triglyceride 165

HDL 57

LDL 208

Now I'm not in the least bit panicked by this.....but I'd like to make any decision about diet or medication that I need to.

The problem is there seems a convincing case that the

1. link between cholesterol and CAD

2. link between saturated fat in diet and blood cholesterol

.....is tentative or weak or ill-thought-out or even bogus.

However, as a scientist myself, I am hard put to think that all those working cardiologists out there, most of whom are not paid by drug companies and have no real axe to grind (apart from the very real one of satisfying their own cognitive dissonance after they've followed the one course so long), are continuing to perpetuate statin medication when a lot of data would call that ill-advised. To recommend reduction in cholesterol when it may be just a co-factor rather than a cause.

On researching the net, it is easy to find

1. Proclamations about what your maximum lipid levels should be and strong, but un-backed-up, advise about prescribing statins.

2. The other side who do give lots of data to overturn the lipid hypothesis.

I don't want to throw the baby out with the bathwater, and I don't want advise based on anecdote.

I'd like to hear the case supporting the lipid hypothesis, the "conventional" side, with quality meta-evidence.

Then I can compare and decide if it's a myth......or not.

Can anyone point me in the right direction?

Cheeryble

Edited by cheeryble
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Posted

"However, as a scientist myself, I am hard put to think that all those working cardiologists out there, most of whom are not paid by drug companies and have no real axe to grind (apart from the very real one of satisfying their own cognitive dissonance after they've followed the one course so long), are continuing to perpetuate statin medication when a lot of data would call that ill-advised. To recommend reduction in cholesterol when it may be just a co-factor rather than a cause."

Just to address this. All doctors need to tow the line and adhere to standard accepted medical practices. That is heavily influenced by the drug companies. If an individual doctor starts doing radical things he'll get into a lot of hot water and possibly lose his licence to practice medicine or at the very least get a wrap on the knuckles by the medical board. There are many examples of doctors losing their licences due to what others considered radical practices. Cardiologists and other specialists invest a lifetime of study and training to get their positions which make them quite wealthy at the upper levels - they're not going to risk anything to endanger their standing.

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Posted
"However, as a scientist myself, I am hard put to think that all those working cardiologists out there, most of whom are not paid by drug companies and have no real axe to grind (apart from the very real one of satisfying their own cognitive dissonance after they've followed the one course so long), are continuing to perpetuate statin medication when a lot of data would call that ill-advised. To recommend reduction in cholesterol when it may be just a co-factor rather than a cause."

Just to address this. All doctors need to tow the line and adhere to standard accepted medical practices. That is heavily influenced by the drug companies. If an individual doctor starts doing radical things he'll get into a lot of hot water and possibly lose his licence to practice medicine or at the very least get a wrap on the knuckles by the medical board. There are many examples of doctors losing their licences due to what others considered radical practices. Cardiologists and other specialists invest a lifetime of study and training to get their positions which make them quite wealthy at the upper levels - they're not going to risk anything to endanger their standing.

Yes it may be a very strong factor Tropo....

Posted (edited)
before any additional yada-yada-yakety-yak read this!

http://www.thaivisa....ost__p__5207126

Whilst I sympathise with your "event" Naam, I'm really looking for either convincing evidence of a causal link between cholesterol levels and CAD (followed by evidence that statin's benificence isn't outweighed by malevolent effects......which looks like it's true in women who I'm sure I've read have the same life expectancy with as without statins), or evidence that statins have a beneficial effect on the real cause of CAD if high cholesterol just happens to be a co-factor.

An alternative route of persuasion would be to tell me what's wrong with the large studies which link higher cholesterol levels to increased life expectancy (especially for the over 60s).

I really am not a Doubting Thomas about professionals just trying to get a balanced picture and come to the best conclusion here Naamcheers Cheeryble

Edited by cheeryble
Posted
before any additional yada-yada-yakety-yak read this!

http://www.thaivisa....ost__p__5207126

Whilst I sympathise with your "event" Naam, I'm really looking for either convincing evidence of a causal link between cholesterol levels and CAD (followed by evidence that statin's benificence isn't outweighed by malevolent effects......which looks like it's true in women who I'm sure I've read have the same life expectancy with as without statins), or evidence that statins have a beneficial effect on the real cause of CAD if high cholesterol just happens to be a co-factor.

An alternative route of persuasion would be to tell me what's wrong with the large studies which link higher cholesterol levels to increased life expectancy (especially for the over 60s).

I really am not a Doubting Thomas about professionals just trying to get a balanced picture and come to the best conclusion here Naamcheers Cheeryble

I am a doubting thomas. Being a doubting thomas is good. I distrust just about everything doctors tell me and research every drug they ever recommend or prescribe. I have a healthy disrespect for doctors, especially here in Asia where it is entirely about business. Private doctors and all the hospitals sell medicine and it is in their interest to sell you as much as possible. Doctors should not sell medicine - it's unethical. High cholesterol gives them a legitimate reason to sell you statins because that is what all doctors are doing all over the world.

If my cholesterol levels were high (they sometimes are), I'll clean up my diet (that does not include cutting back on healthy high cholesterol foods such as eggs), increase my consumption of essential fatty acids and do more exercise. I will never take cholesterol lowering drugs.

Posted

If my cholesterol levels were high (they sometimes are), I'll clean up my diet (that does not include cutting back on healthy high cholesterol foods such as eggs), increase my consumption of essential fatty acids and do more exercise. I will never take cholesterol lowering drugs.

I am not going to get into the debate of whether high cholesterol puts you at greater risk of heart attack and stroke. If you are trying to lower your cholesterol through dietary changes, it might work and you should certainly try it, but it doesn't work for most people. It didn't work for me and I was very diligent about the diet and exercise (and still am.) In my case diet and exercise lowered total cholesterol from 300 to 240, worthwhile but not good enough. With diet, daily exercise, weight loss, and niacin it is down to 189 or lower.

It's one thing to take a skeptical attitude towards medicine and another thing to make decisions out of simple truculence without regard to effectiveness. Good luck with that.

Posted (edited)

Tropo

what i meant to say was I am always cautious about medical matters especially here, but I'm not an automatic naysayer.

In this case I'm merely looking for real evidence....and it's interesting that 24 hours after asking for the big evidence behind completely ingrained advice about cholesterol and statins.....such as by the American Heart Association (whose website only gives the standard advice with no persuasive references).....nothing has shown up.

Capt Haddock

I must admit some surprise....

From what I've read a low fat diet has a negligable effect on serum cholesterol.

Yet unless it was happenstance you happened to have a high level for one test and low level for the next you got your level down from 300 to 240.

Very impressive!

I'd be very happy to see that happen in my case.

Was your diet about low fat or was it low calorie or low carbo/sugar?

Weight loss may have been a factor. Were you overweight? Did you lose much?

cheers Cheeryble

Edited by cheeryble
Posted

If my cholesterol levels were high (they sometimes are), I'll clean up my diet (that does not include cutting back on healthy high cholesterol foods such as eggs), increase my consumption of essential fatty acids and do more exercise. I will never take cholesterol lowering drugs.

I am not going to get into the debate of whether high cholesterol puts you at greater risk of heart attack and stroke. If you are trying to lower your cholesterol through dietary changes, it might work and you should certainly try it, but it doesn't work for most people. It didn't work for me and I was very diligent about the diet and exercise (and still am.) In my case diet and exercise lowered total cholesterol from 300 to 240, worthwhile but not good enough. With diet, daily exercise, weight loss, and niacin it is down to 189 or lower.

It's one thing to take a skeptical attitude towards medicine and another thing to make decisions out of simple truculence without regard to effectiveness. Good luck with that.

I would not be the slightest bit concerned about a cholesterol level of 240. Your problem is probably diet anyway - try harder.

You wish me good luck. I think you're the probably the one in need of luck - especially if you use drugs to lower it.

Posted

Capt Haddock

I must admit some surprise....

From what I've read a low fat diet has a negligable effect on serum cholesterol.

Yet unless it was happenstance you happened to have a high level for one test and low level for the next you got your level down from 300 to 240.

Very impressive!

I'd be very happy to see that happen in my case.

Was your diet about low fat or was it low calorie or low carbo/sugar?

Weight loss may have been a factor. Were you overweight? Did you lose much?

cheers Cheeryble

My diet was focused on lowering fat. If I remember correctly, I did not experience weight loss during that period since I did not reduce caloric intake. I never tried any of the low carb diets. I think the simplest explanation is that reducing saturated fats does indeed lower cholesterol, despite what you may have read. Try it yourself.

Posted

I am a doubting thomas. Being a doubting thomas is good. I distrust just about everything doctors tell me and research every drug they ever recommend or prescribe. I have a healthy disrespect for doctors, especially here in Asia where it is entirely about business. Private doctors and all the hospitals sell medicine and it is in their interest to sell you as much as possible. Doctors should not sell medicine - it's unethical. High cholesterol gives them a legitimate reason to sell you statins because that is what all doctors are doing all over the world.

If my cholesterol levels were high (they sometimes are), I'll clean up my diet (that does not include cutting back on healthy high cholesterol foods such as eggs), increase my consumption of essential fatty acids and do more exercise. I will never take cholesterol lowering drugs.

perhaps you are not aware of the fact that diet has an effect of only 15-20% on a body's cholesterol levels. cholesterol is mainly produced by the body itself! three sisters of my wife are strict vegetarians. all of them had dangerously high levels and are since years on statins. my wife is a 90% vegetarian, over years healthy and no problems. but recent blood tests showed her CHOL levels sky high. now she is on statins too.

by the way... the medics in Germany who treated me have no interest and do not get any kickbacks from any medication we buy in Foodland's pharmacy in Pattaya no matter whether it's statins or betablockers whistling.gif

  • Like 1
Posted

perhaps you are not aware of the fact that diet has an effect of only 15-20% on a body's cholesterol levels. cholesterol is mainly produced by the body itself! three sisters of my wife are strict vegetarians. all of them had dangerously high levels and are since years on statins. my wife is a 90% vegetarian, over years healthy and no problems. but recent blood tests showed her CHOL levels sky high. now she is on statins too.

by the way... the medics in Germany who treated me have no interest and do not get any kickbacks from any medication we buy in Foodland's pharmacy in Pattaya no matter whether it's statins or betablockers whistling.gif

I don't know. Have you tried 3 or 4 tablespoons of flaxseed oil every day?... or just ground flaxseeds? Were the diets they tried high enough in essential fatty acids? I figure, unless your supplementing a vegetarian diet would be very low in omega 3, 6 and 9.

How could anyone say that diet doesn't have much of an effect on cholesterol levels. Did they try every possible diet? This is obviously impossible. Were they experimenting with low cholesterol foods?

I do know that I can eat 6 eggs per day and stay under 200. Maybe if your vegetarian wife started eating lots of eggs, which provide good fats, she may be able to get her cholesterol levels down without the need for drugs.

Posted

perhaps you are not aware of the fact that diet has an effect of only 15-20% on a body's cholesterol levels. cholesterol is mainly produced by the body itself! three sisters of my wife are strict vegetarians. all of them had dangerously high levels and are since years on statins. my wife is a 90% vegetarian, over years healthy and no problems. but recent blood tests showed her CHOL levels sky high. now she is on statins too.

by the way... the medics in Germany who treated me have no interest and do not get any kickbacks from any medication we buy in Foodland's pharmacy in Pattaya no matter whether it's statins or betablockers whistling.gif

How could anyone say that diet doesn't have much of an effect on cholesterol levels. Did they try every possible diet? This is obviously impossible. Were they experimenting with low cholesterol foods?

I think Naam's speaking of a low saturated fat diet which indeed gets turned on it's head by a lot of people.

I for one thought of the vascular system like an old clay pipe under the kitchen in which all the fat going down the drain sticks to the sides and clogs up. I think this is how many people visualise things, but the fact is every single cell in the artery walls is a very active cell which does specific functions (one of which must be staying free of coatings) and is no way an old clay pipe.

Once again I'm here trying to get backup evidence for the "conventional" lipid hypothesis, and it's now a couple of days with nothing......kind of surprising.

Cheeryble

Posted (edited)

Once again I'm here trying to get backup evidence for the "conventional" lipid hypothesis, and it's now a couple of days with nothing......kind of surprising.

Cheeryble

It's not surprising at all. There's a lot of info on this debate readily available on the web. Coming out against conventional medical "wisdom" is a fruitless task. A good example would be questioning the HIV causes AIDS hypothesis. This is not quite in the same league, but getting close.

Why don't you link some useful info sites?

I've already got my hands full with "you don't eat your way to diabetes - and diabetes is genetically determined"... good luck with yours.

Edited by tropo
Posted

Once again I'm here trying to get backup evidence for the "conventional" lipid hypothesis, and it's now a couple of days with nothing......kind of surprising.

Cheeryble

Maybe it is because people have better things to do with their time than list all the research for you. I'm sure you can easily find it yourself. The problem seems to be that you don't want to believe it.

BTW if I were you I'd be at least as concerned with my triglyceride level as with the LDL.

  • Like 1
Posted

OP, I don't know about you, but I have had some borderline 'ok' readings in the past and I don't even eat cheese, ice cream, or cake every day (my problem is fried foods and meats)... perhaps the reason your results are dodgy is because you *do* eat them every day and there *is* a link? Gosh, I dunno.... :rolleyes:

Posted

Once again I'm here trying to get backup evidence for the "conventional" lipid hypothesis, and it's now a couple of days with nothing......kind of surprising.

Cheeryble

Maybe it is because people have better things to do with their time than list all the research for you. I'm sure you can easily find it yourself. The problem seems to be that you don't want to believe it.

Hi Sheryl

I went to quite a few sites like American Heart Assoc, Mayo Clinic etc. When I found nothing I thought I'd ask here where there are people who may have already checked out the same thing. I am doing this because I'm not an automatic skeptic.....in fact I'm already making an effort to amend my diet. But I've come across stats from big studies which say things like women's life expectancy does not alter with the use of statins, men live longest with total cholesterol of 200-240 etc, and I think some investigation is at least warranted.

As no real backup for the lipid hypothesis has been forthcoming here certainly I shall make a further effort to find more out myself.

BTW if I were you I'd be at least as concerned with my triglyceride level as with the LDL.

What particular consequences does that level have Sheryl?

OP, I don't know about you, but I have had some borderline 'ok' readings in the past and I don't even eat cheese, ice cream, or cake every day (my problem is fried foods and meats)... perhaps the reason your results are dodgy is because you *do* eat them every day and there *is* a link? Gosh, I dunno.... rolleyes.gif

Yes I tend to be hedonistic. I am banning cake, reducing cocoa and cheese, and ate a nice greasy mackerel for lunch yesterday.

Did a bit on the bike and 24 lengths of the pool last night but that's pretty normal.

Cheers Cheeryble

Posted
I for one thought of the vascular system like an old clay pipe under the kitchen in which all the fat going down the drain sticks to the sides and clogs up.

that's exactly what my coronaries looked like, enhanced by the contrast medium during a scan. i still have the DVD which was made during that scan.

and because they were clogged they cut me open with an electric jigsaw, spread the ribs apart with two car jacks tongue.png, cut the clogged parts out and replaced them with [not so clogged] "cuttings" from my right leg.

what else can i tell you? that after a surgery like this you know how feeble a 118 year old feels? that, for a week or two, it takes you five minutes to pull on a pair of socks? that it takes two to three months for the chestbone to heal and during that time you have to sleep on your back?

Posted

joke aside Tropo, ref "trying flaxseed oil". for more than three years i had several times daily symptoms which were conform with heart problems (chest pain and pain in left arm) but which lasted only a few minutes because i "cured" them with a sip of that bitter Italian liqueur "Fernet" which made me belch and the pain disappeared. my own diagnosis -i hold a doctorate in physics and a master's in mechanical engineering and therefore know each and everything bah.gif - was stress caused by building a home being for one year, being the first on the construction site and the last one to go and then another two years to rectify the rubbish construction execution.

well, it turned out i knew shite² because when my wife forced me with horrible threats to have a CAT scan done it was too late for "flaxseed". the Thai cardiologist even insisted that a long range flight to Europe was too dangerous and either surgery or stents should be done in BKK if possible "yesterday".

Posted (edited)

joke aside Tropo, ref "trying flaxseed oil". for more than three years i had several times daily symptoms which were conform with heart problems (chest pain and pain in left arm) but which lasted only a few minutes because i "cured" them with a sip of that bitter Italian liqueur "Fernet" which made me belch and the pain disappeared. my own diagnosis -i hold a doctorate in physics and a master's in mechanical engineering and therefore know each and everything bah.gif - was stress caused by building a home being for one year, being the first on the construction site and the last one to go and then another two years to rectify the rubbish construction execution.

well, it turned out i knew shite² because when my wife forced me with horrible threats to have a CAT scan done it was too late for "flaxseed". the Thai cardiologist even insisted that a long range flight to Europe was too dangerous and either surgery or stents should be done in BKK if possible "yesterday".

My father was also too late for flaxseed. He died in 1979. But so what? I was discussing high cholesterol levels and possible ways to reduce them. If you're going into cardiac arrest, then it's time to pray and take all the drugs the doctors are recommending.

Stress of building a house in Thailand did not mess you up. Everyone has stress - It was your ability to cope with stress and your general health which did you in along with a deficient diet. Perhaps your doctorate and masters degree played a part too - you were too smart for you own good.

Edited by tropo
Posted

I would never take statins as they are worse for you than the high cholesterol.

Anyway the whole things is most cholesterol does not come from the food you eat but from your liver.

If you are really worried about cholesterol levels clean your whole act up.

Take fish oil or flaxseed , exercise and look after your liver.

I am with Tropo on this dont believe much of what doctors tell you. Once you start depending on doctors you will lose control of your health.

Posted (edited)

The case for and against the lipid hypothesis and the dietary fat hypothesis is well explained by Chris Masterjohn in many of his writings and podcasts. Google "chris masterjohn podcasts". There are three outstanding podcasts in the last few months.

As CM says, if your cholesterol is over 250 you probably have a metabolic issue, the most obvious of which is thyroid. Thyroid is required to metabolize cholesterol. In the case of chronic stress the body produces an isomer of the active thyroid hormone which slows down the metabolism resulting in a rise in cholesterol.

I've just been through the mill of high cholesterol anxiety. My TC was as high as 350 last year. I brought it down to 150 with thyroid supplementation. All the time I was on a diet very high in saturated fats: coconut oil, butter, meat, liver, cream. I've since weaned of the thyroid meds and have adjusted my diet by increasing carbs a bit - but not altering the saturated fat element. For the last three months, testing monthly, my TC sits at around 230. I'm quite satisfied with that.

The best evidence that i have found correlating heart disease with cholesterol is the chart in this article:

http://perfecthealthdiet.com/?p=3836

The chart shows the sweet spot for cholesterol at around 210 to 220. It also shows a very weak correlation between heart disease and total cholesterol in absolute terms. In other words, while the relative risk of heart disease varies more than three-fold between 200 and 250, the absolute risk is still less than one in a thousand for TC less than 250 mg/dl.

There are also claims that cholesterol is part of the innate immune system and is the first line of defence in fighting bacteria. It makes sense then, as we age and accumulate more chronic infections, that our cholesterol levels should rise slightly. The idea of a 'one size fits all ages' optimal cholesterol level is, according to this theory, also suspect.

Edited by goatfarmer
Posted

Total cholesterol is no longer used as an indicator of risk. Have to look at the LDL, HDL levels and their ratio. While it is true that anyone with a TC well under 200 is unlikely to have overly high LDL, and anyone with a TC of over 300 almost surely does, people whose TC falls between those extremes (which is most of us) may or may not have elevated LDC.

Posted

The case for and against the lipid hypothesis and the dietary fat hypothesis is well explained by Chris Masterjohn in many of his writings and podcasts. Google "chris masterjohn podcasts". There are three outstanding podcasts in the last few months.

As CM says, if your cholesterol is over 250 you probably have a metabolic issue, the most obvious of which is thyroid. Thyroid is required to metabolize cholesterol. In the case of chronic stress the body produces an isomer of the active thyroid hormone which slows down the metabolism resulting in a rise in cholesterol.

I've just been through the mill of high cholesterol anxiety. My TC was as high as 350 last year. I brought it down to 150 with thyroid supplementation. All the time I was on a diet very high in saturated fats: coconut oil, butter, meat, liver, cream. I've since weaned of the thyroid meds and have adjusted my diet by increasing carbs a bit - but not altering the saturated fat element. For the last three months, testing monthly, my TC sits at around 230. I'm quite satisfied with that.

The best evidence that i have found correlating heart disease with cholesterol is the chart in this article:

http://perfecthealthdiet.com/?p=3836

The chart shows the sweet spot for cholesterol at around 210 to 220. It also shows a very weak correlation between heart disease and total cholesterol in absolute terms. In other words, while the relative risk of heart disease varies more than three-fold between 200 and 250, the absolute risk is still less than one in a thousand for TC less than 250 mg/dl.

There are also claims that cholesterol is part of the innate immune system and is the first line of defence in fighting bacteria. It makes sense then, as we age and accumulate more chronic infections, that our cholesterol levels should rise slightly. The idea of a 'one size fits all ages' optimal cholesterol level is, according to this theory, also suspect.

Some good info there... thanks!

Posted

For me, I have been taking generic Pravastatin Sodium 20 mg. daily in the evening for 2 years now at a cost of $2 for a 90 day supply from Walmart ($10-$8 BC/BS=$2) and made by Teva in the Czech Republic. It dropped my Cholesterol from 268+, etc. down to normal ranges and liver and all other tests now continue to be normal in my semiannual blood tests. My wife has a different Dr. but is on the same generic med and she had a bigger drop to normal in her Cholesterol levels but she also takes Triliplix as her Triglicerides were very high too.

Meds don't have have to be costly, but my wife's Triliplix is, so I can't recommend that one as her Dr. said its probably temporary and she may take her off of Triliplix.

Too much cholesterol is also associated with old timer's disease.

Everyone is different so your experience may vary, but it works for us and doesn't need to be costly.

Posted (edited)

Lots of confusing info out there. Hard to know what to believe.

The following guidelines might help in evaluating competing claims:

i. Prefer the complex to the simple. The human body is a complex organism. Complex explanations are more persuasive than simple ones. For example, "atherosclerosis is caused by oxidation and glycation (caramelization) of small particle size LDL cholesterol" is to be preferred to "cholesterol and saturated fat clog your arteries".

ii. Prefer claims backed by evidence. Although it's difficult for most of us interpret medical research we can at least give more credence to claims which have some evidentiary support rather than those which don't.

iii. Prefer claims which are quantifiable. For example, see the chart I posted above, which attempts to quantify correlation of heart disease with cholesterol in 100's per 100,000s of population. Consider claims of absolute risk and don't be gulled by claims of relative risk. "Four times likely" can spook you unnecessarily when the absolute risk in question is nonetheless less than 1 in a hundred.

iv. Prefer theories which identify long term trends. For example, the long term trend of increased cases of heart disease in western population correlates with the long term trend of increased obesity and diabetes which, in turn, correlates with the long term trend in consumption of polyunsaturated fats (industrial seed oils), high fructose corn syrup, trans fats, increased consumption of sugar and the genetic transformation of triticum aestivum, (bread wheat).

v. Consider theories based on evolution; for example, the optimal diet is that which humans have been eating for most of their time on the planet. Is it plausible that we have evolved to be vulnerable to saturated fats when we have been eating them for hundreds of thousands of years?

vi. Do not accept claims based on the authority of the claimant. In other words, don't follow your doctor blindly. The medical profession is notoriously conservative. How long did it take them to abandon Galen and Hippocrates in favour of William Harvey and Thomas Sydenham? Times haven't changed. As Max Planck said, "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." (giggle.gif pardon my hypocrisy.)

Edited by goatfarmer

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